Provider Demographics
NPI:1578713954
Name:MAYFIELD, JESSICA (LPC, CAADC, SAP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LPC, CAADC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15133-3235
Mailing Address - Country:US
Mailing Address - Phone:412-334-2655
Mailing Address - Fax:
Practice Address - Street 1:1801 LINCOLN WAY
Practice Address - Street 2:BUILDING 2
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131
Practice Address - Country:US
Practice Address - Phone:412-334-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional